Date: Sun, 12 Feb 1995 11:12:00 EST
From: "Kathleen M. Gura"@hub.tch.harvard.edu
Subject: Vit K/octreotide
Content-type: TEXT/PLAIN
Posting-date: Sun, 12 Feb 1995 00:00:00 EST
A1-type: DOCUMENT
>>Hi!
>>Regarding your question on Vitamin K in IVPB’s, check with Trissel (8th
>>edition, pg. 868) as it summarizes nicely the stability information you
>>had requested (defintely has stability greater than use immediately).
>>We have also done high dose octreotide infusions, we have had similar
>>situations in 2 patients, both with VIPoma’s. In both cases, GI was involved
>>in titrating dose to response. Also, check the AHFS ‘94 pg 2484 as they
discus
>>some high dose octreotide in the dosing section.
>>Hope this helped.
>>Kathleen Gura, RPh BCNSP
>>Clinical Pharmacist
>>Children’s Hospital
>>Boston, MA
–Boundary (ID 9of0NAeEO5U+g5RdozTeLQ)–
- Hide quoted text — Show quoted text -
> I am reading the manifacturer’s insert here :
>VIPomas : Daily dosage of 200ug to 300 ug in 2 to 4 divided doses are
>recommended during the first 2 weeks of therapy (range 150 to 750 ug) to
>control the symptoms. Usually doses above 450 ug are not required.
> Elsewhere it says that the preferred site of administration is
>SC,while IV boluses have been used on an emergency basis.
> Of course this may have changed in the last little while, but I
>really have to ask why they want to go by IV infusion ?? Besides, if they
>are just starting therapy, that’s a hefty kind of a dose. I know I am not
>helping any with the stability qtn, but the dose here has me all intrigued.
>Wael hadd…@mcmail.cis.mcmaster.ca
>and he wrote:
>Hi
> From what I remember the 1500 mcg were for carcinoid tumours. So,
>1500 mcg maybe safe, but is it necessary ?
> I can see that if they are going at 1200 mcg a day, it would be
>difficult to go with SC or even with IV bolus ….
> My advice based on very limited experience with Sandostatin is to try and go
>with a
>smaller dose first and see what happens on a daily basis. I would go with
>200 mcg t.i.d. sc before going with the IV infusion.
\\While at the Univ. of Maryland Medical System, I recall that we put
\\sandostatin in TPN solutions. The nutrition support team director, Gail
\\Rosen, did some stability and compatibility studies. I’m not sure where
\\they were published. I believe that she presented the data as posters at
\\either the ASHP Midyear, or an ASPEN meeting. I don’t remember what dose
\\they used either. These were long-term TPN patients who either had VIPoma’s
\\or high-ouput fistulas if my memory serves me correctly. Also, I believe
\\that sandostatin affected the insulin availability if there was insulin in
\\the TPN. You could contact Gail for the specific details, 410-328-6936. I
\imagine that Sandoz has the information as well.
\\Claudio Robles for Eliza Hoernle, Pharm.D.,
\\Pediatric Clinical Coordinator,
\\Cook County Hospital
\\Chicago, IL
Thank you for replying…as for the Vit K question (re: length of stability
after mixing) I mentioned the section in
Trissel’s and the Rxist said she checked that but that possibly not close
enough and that she would look again.
As for the Sandostatin drip, the Rxist that was involved with that didn’t
have any background information as to
the patient’s condition in particular. We have had a few different pt’s
within the past couple of months with a
high dose Sandostatin drip and as they were popping up in more RXist’s
consciousness, they were looking for any experiences in particular from others
who’ve had more experience than we. Thank you